Ophthalmology Billing Services: Compare Companies and Costs

Ophthalmology billing services take over the work of getting your eye practice paid. That means claims, payment posting, denials, and patient balances. Get the exact work and fee in writing.

Of the seven companies below, two publish a percentage or range on the pages reviewed. AdvancedMD lists a typical range of 4–8% of practice collections. Transcure lists around 3–5% of monthly collections with no setup fee. For the other five, we did not find a price on the reviewed pages.

Before you compare rates, ask one question: does the percentage apply to drug payments? If your practice injects drugs like Eylea or Vabysmo, that answer can change your bill more than the rate does. In the example below, a 3% quote costs $36,000 a year more than a 5% quote.

We don't do billing. We compare the companies that do. You can use everything on this page without giving an email or a phone number.

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Company details come from each company's own website. We have not tested their work. Read how we research and how we make money. Sources checked October 6, 2026.

Ophthalmology billing companies to compare

These seven are listed A to Z. It is not a ranking.

"Not published" means we did not find it on the company pages reviewed. It does not mean the fee is zero or the service is missing. Ask for it in writing.

One gap runs through the whole table. The company pages reviewed did not explain how their fees treat drug payments. That is the first thing to ask.

Where to start

Pick the line that sounds like you. These are starting points from what each company says about itself, not proof of fit.

• You run a retina practice. Start with RetinaBilling, which says it does only retina, and Medusind, which names injection-based services. Neither reviewed page publishes a price.
• You own a surgery center too. Medusind, ModMed, and Transcure publish descriptions of ASC (ambulatory surgery center) billing support. Ask each whether its quote covers physician claims, facility claims, or both.
• You want a price before you talk to anyone. AdvancedMD and Transcure publish a range. Neither reviewed page explains whether drug payments are included in the percentage-fee base.
• You already use ModMed or AdvancedMD. Each sells billing on its own software. Get one outside quote too, so you have something to compare.
• You want to keep your current system. MedCare MSO, Medusind, Practolytics, RetinaBilling, and Transcure each say they work with existing systems. AdvancedMD says you can keep another EHR too. Ask for a current client on your exact setup.
• You bill vision plans as well as medical insurance. MedCare MSO and Practolytics both mention vision plans. Confirm the exact plans.

How we picked these seven. Each one publicly describes ophthalmology or retina billing, or publishes a price an eye practice can use as a reference point. We read each company's own pages on October 6, 2026. This is a short list, not the whole market. Leaving a company out says nothing about its quality.

Ready to talk to one? These go straight to each company's own site.

Not ready yet? Run the numbers first.

Compare the cost behind two billing quotes

Compare quotes in dollars, not percentages. Use the same monthly collections for both. Then check what each percentage applies to.

Why a 3% quote can cost more than a 5% quote

Here is a made-up retina practice. Each month it collects $120,000 for exams, tests, and surgery. It also collects $180,000 in drug payments.

Quote A has the lower rate. It still costs $3,000 more a month, or $36,000 more a year. The reason is simple. Quote A charges 3% on $300,000. Quote B charges 5% on $120,000.

Put another way, Quote A's bill is 7.5% of the money that isn't drug repayment.

Two cautions. These are made-up quotes, not offers from the companies above. The example assumes no minimum or extra charges. And Quote B's lower fee is comparable only if it covers the same work, including drug billing. A zero fee on drug payments does not prove the work is included.

Now try your own numbers.

Get the quote request to send

Why drug payments matter so much

With buy-and-bill, your practice buys the drug and later seeks reimbursement. That payment also has to cover what you spent on the drug. It is not all profit.

Medicare shows why this matters. For most drugs separately payable under Medicare Part B, the payment limit is 106% of the drug's average sales price, or ASP, before applicable payment adjustments. ASP is based on the manufacturer's sales prices, accounting for discounts and other price concessions. CMS posts the payment limits every quarter.

Take a drug with an ASP of $1,000, a round number to keep the math easy.

• The payment limit before adjustments is $1,060. That is $60 above ASP.
• A 3% billing fee on $1,060 is $31.80. That is more than half of the $60.
• A 5% billing fee on $1,060 is $53. That is almost all of it.

This example uses the payment limit before sequestration and assumes full collection, including any patient or supplemental-insurer share. Sequestration is the 2% cut to Medicare's own payment; it does not reduce the patient's cost-sharing. The example also assumes you buy at exactly ASP. Your purchase price can be higher or lower, and private-plan terms differ.

If a quote charges its percentage on drug payments, ask for one of three changes in writing:

1. Leave drug payments out of the fee.
2. Charge a lower rate on drug payments.
3. Charge a flat fee per drug claim.

Check for a monthly minimum

Some contracts charge the percentage or a minimum, whichever is more. That matters most for a small or new practice.

Here is a made-up 4% fee with a $1,500 monthly minimum:

• Collect $10,000 in a month. 4% is $400, so you pay the $1,500 minimum. That is 15% of what you collected.
• Collect $40,000 in a month. 4% is $1,600, so you pay $1,600. That is 4%.

Our homepage has a worked example using one company's published minimum.

Other money the percentage might touch

Ask about each of these by name.

• Money your front desk collects. Medicare allows additional patient charges for noncovered presbyopia- or astigmatism-correcting lens features and specified related services. It does not permit extra charges for services already covered as part of conventional cataract surgery. If your staff collects those amounts—or money for cosmetic work, LASIK, or optical sales—ask whether the billing company's percentage applies.
• Surgery center claims. The facility's claim is separate from the surgeon's claim. Ask whether each is included in the quote and what each costs.
• Old unpaid claims. Ask whether older balances are included or priced separately, and which dates and claims count as old work.
• Money that gets taken back. When an insurer reverses a payment, ask whether the fee on it comes back to you.

What "full service" should cover in an eye practice

"Full service" means different things at different companies. Give every task an owner and a price.

The quote request below asks companies to mark the billing tasks as included, extra, yours, or not offered, then confirm reporting and exit terms.

How to tell if a company really knows eye care

A web page that says "ophthalmology" is not proof. Ask for references you can contact and a walkthrough with made-up data. Here are five things worth testing, and why each one matters.

1. An exam and an injection on the same day

Medicare's global surgery guide says a visit on the day of a minor procedure generally isn't paid separately. An intravitreal injection is treated as a minor procedure. A separate same-day visit charge needs a significant, separately identifiable service beyond the usual work of the injection, supported by the medical record.

Getting this wrong is costly. Federal auditors reviewed one California eye clinic's 2018 Medicare payments for injections and same-day services. The audit covered $4.3 million in payments and reviewed a sample of 100 beneficiary days. The injections were mostly billed correctly. But 301 of the 627 sampled services and drugs did not meet Medicare's rules. The auditors recommended the clinic refund an estimated $398,625.

The refund request went to the clinic, not to a billing company.

Ask: "Show us how you review a same-day exam and injection before the claim goes out." A good answer talks about the doctor's notes, not just a code.

2. Drug units and waste

For drugs separately payable under Medicare Part B from single-dose or single-use containers, CMS requires JW for eligible discarded amounts and JZ when no discarded amount is eligible for payment. JZ has been required since July 1, 2023; JW since January 1, 2017. Multiple-dose containers are outside this rule, and billing-unit rules still matter.

Ask: "Who checks the drug code, the units, and the waste code on every claim? Who follows an unpaid drug claim until it's resolved?"

3. Surgery follow-up and shared care

Under Medicare, a procedure with a 90-day global period includes routine related follow-up in the surgical payment. For a formal transfer of postoperative care, the providers report the same procedure code with the applicable modifiers: 54 for surgical care and 55 for postoperative management. Both keep the written transfer agreement in the patient's record. Medicare's guide also requires modifier 54 for a planned partial global package with an expected informal transfer. These modifiers do not apply to the surgery center's facility fee.

Ask: "How do you track surgery dates and shared care? Do you bill both sides or only ours?"

4. Medical eye care versus routine vision

Original Medicare doesn't cover routine eye exams for glasses or contacts. Some Medicare Advantage plans add vision benefits. A patient may have both medical and vision benefits. Check the visit's purpose, documentation, and plan rules before deciding which claim to submit.

Ask: "Which of our vision plans do you bill? Who decides which plan a visit goes to, your team or our front desk?"

5. Their own numbers

Several of these companies post results. MedCare MSO lists a 98.5% first-pass clean claim rate. Practolytics advertises a 98%+ clean claim rate. Transcure displays different clean-claim figures in different sections of the same page. Medusind says "up to 30% more cash collected."

The reviewed specialty pages did not provide enough detail to compare those results on the same basis. Treat them as ads until you see the detail.

Ask: "What period and which clients is that number from? Can we see a sample report with the definitions on it?"

Check your software and your reports

Settle the software question before you compare prices. A system change can add migration, training, and access work to the billing transition.

The companies describe their software support this way:

• They advertise support for your existing system. MedCare MSO, Medusind, Practolytics, RetinaBilling, and Transcure each say they can work with existing systems. Verify your exact setup.
• They include or integrate their own software with billing. AdvancedMD includes its software but says you can keep another EHR. ModMed presents its billing service with its EHR and practice management software; confirm what your contract requires.

Give each company your exact EHR, practice management system, and clearinghouse (the service that passes your claims to insurers). Ask for a current client on the same setup.

Then ask for a sample monthly report with made-up data. It should show:

• New claims sent
• Claims rejected before they reached the insurer
• Claims denied by the insurer
• Money paid
• Unpaid balances by age
• Drug claims on their own line

"Accepted by the clearinghouse" is not the same as "paid." Make sure the report shows both.

If you would rather keep billing with your own team and just need better tools, see "Keeping billing with your team" on our homepage.

Plan the switch before you sign

Claims can stall during a handoff when nobody is assigned to finish them. Decide who owns what first.

1. Read your current contract. Find the notice period, any exit charge, and who finishes the claims already sent.
2. Agree on a cutoff rule. Specify whether it uses the date of service or another date, who finishes open claims and appeals, and who charges for collections received after the handoff. Put the responsibilities in writing.
3. List the open work. Unpaid claims, appeals in progress, approvals on file, and credits owed.
4. Get your data and logins. Full claim and payment history. Insurer portal access. Make sure the clearinghouse and electronic payment enrollments are in your practice's name.
5. Sign a business associate agreement first. For a billing vendor handling protected patient information on behalf of a HIPAA-covered practice, put the required agreement in place before sharing that information.
6. Watch drug claims weekly at the start. If you buy and bill high-cost drugs, reconcile stock, administered doses, and documented waste with claims and payments. Follow up on unbilled administrations, denied or unpaid claims, and unexplained differences.

There is no honest "switch in X days" number. Timing depends on your notice period, insurer enrollments, and system access.

Send the same request to every company

Send every company the same numbers and the same list of work. Then the answers line up. This is the short version. The download has all 28 questions.

Subject: Ophthalmology billing quote request — please price this scenario

We are comparing billing companies for our eye practice. Please reply by
email and price the scenario below.

Our practice: [state, locations, doctors, what we do, EHR and clearinghouse]

Price this same month for us:
- Money we collect in a month, drugs left out: $[amount]
- Drug payments we collect in a month: $[amount]
- Of the non-drug total above, our own staff collects $[amount] for
  [premium lens upgrades / cosmetic work / optical sales / other].
  This amount is already in the total, not additional.

Exclude separately priced old-claim recoveries from these ongoing
collection figures; quote that work separately.

1. What is your fee, and what exactly is it a percentage of?
2. Does the percentage apply to drug payments? If yes, will you leave
   drugs out, lower the rate on them, or charge a flat fee per drug claim?
3. Does it apply to money our own staff collects, like premium lens
   upgrades, cosmetic work, and optical sales?
4. Is there a monthly minimum? What else do you charge for?
5. Which tasks are included, which cost extra, and which stay with us?
6. How many eye practices do you bill today? May we contact two?
7. Will you work inside our current system?
8. What are the term, the notice to cancel, and any exit charge?

Please show the monthly bill and the first-year total for this scenario.
This request has business numbers only. No patient information.

Download the full quote request

Choose companies to send it to

Questions before you choose

Is outsourcing cheaper than an in-house biller?

Do the same math for both. Divide what in-house billing costs you in a year by what that staff collects in a year. Count pay, benefits, software, and cover for sick days and vacations.

A made-up example: $70,000 a year, all in, to bill $1,440,000 in non-drug collections. That works out to 4.9%. Compare it with a quote's bill for the same period and collections, using the tool above. Include the same work, drug billing where relevant, and software and staff costs you would keep after outsourcing.

Do we need a company that only does ophthalmology?

Not always. You need proof that it bills eye care today. Ask for two current clients in your subspecialty, and ask who would work your account.

Who is responsible if the billing company gets a claim wrong?

Ask before you sign. In the federal audit above, the refund recommendation went to the clinic. Have your attorney review what the contract says about errors. This page is general information, not legal advice.

Do these companies bill optometry too?

MedCare MSO says it bills both ophthalmology and optometry. Practolytics says it handles medical and vision plans. For the others, ask.

Will MedicalBillingSelect get quotes for us?

No. You contact the companies yourself. We don't submit quote requests or send your contact details to billing companies for you. How MedicalBillingSelect works.

I'm a patient with a bill from my eye doctor. Can you help?

We can't see patient accounts. Call the billing number printed on your statement. Your eye doctor's office can also look up your account.

How we checked

We read each company's own website on October 6, 2026. We recorded what it says about eye care, price, and software. We did not test any company or verify its results. Details we could not find on the reviewed pages are marked "Not published."

Rules about Medicare and privacy come from government sources, linked next to each claim: CMS, Medicare.gov, the HHS Office of Inspector General, HHS, and the Social Security Act. The quote examples are made up and labeled that way.

Prices and terms change. If something here is out of date, tell us and we'll review it. More on how we research and compare and how we make money.

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